Healthcare Provider Details

I. General information

NPI: 1851221394
Provider Name (Legal Business Name): DR. BRANDON RUSSELL TYLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

891 STONE HEDGE CV
COLLIERVILLE TN
38017-7379
US

IV. Provider business mailing address

891 STONE HEDGE CV
COLLIERVILLE TN
38017-7379
US

V. Phone/Fax

Practice location:
  • Phone: 901-493-1265
  • Fax:
Mailing address:
  • Phone: 901-493-1265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4071
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: